| Title |
Cryptococcus-Related Immune Reconstitution Inflammatory Syndrome (IRIS): Pathogenesis and its Clinical Implications
|
|---|---|
| Published in |
Current Fungal Infection Reports, August 2011
|
| DOI | 10.1007/s12281-011-0064-8 |
| Pubmed ID | |
| Authors |
Darin L. Wiesner, David R. Boulware |
| Abstract |
This review provides an overview of Cryptococcus neoformans immunology and focuses on the pathogenesis of Cryptococcus-related paradoxical immune reconstitution inflammatory syndrome (IRIS). Cryptococcal IRIS has three phases: (1) before antiretroviral therapy (ART), with a paucity of cerebrospinal fluid (CSF) inflammation and defects in antigen clearance; (2) during initial ART immune recovery, with pro-inflammatory signaling by antigen-presenting cells without an effector response; and (3) at IRIS, a cytokine storm with a predominant type-1 helper T-cell (Th(1)) interferon-gamma (IFN-γ) response. Understanding IRIS pathogenesis allows for risk stratification and customization of HIV/AIDS care. In brief, persons at high IRIS risk may benefit from enhancing microbiologic clearance by use of adjunctive agents in combination with amphotericin, prolonging initial induction therapy, and/or increasing the initial consolidation antifungal therapy dose to at least 800 mg of fluconazole daily until the 2-week CSF culture is known to be sterile. Prophylactic anti-inflammatory therapies or undue delay of ART initiation in an attempt to prevent IRIS is unwarranted and may be dangerous. |
Mendeley readers
The data shown below were compiled from readership statistics for 64 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Netherlands | 1 | 2% |
| Brazil | 1 | 2% |
| Unknown | 62 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 12 | 19% |
| Researcher | 8 | 13% |
| Student > Ph. D. Student | 8 | 13% |
| Student > Postgraduate | 7 | 11% |
| Lecturer > Senior Lecturer | 4 | 6% |
| Other | 15 | 23% |
| Unknown | 10 | 16% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 27 | 42% |
| Agricultural and Biological Sciences | 10 | 16% |
| Immunology and Microbiology | 8 | 13% |
| Biochemistry, Genetics and Molecular Biology | 4 | 6% |
| Social Sciences | 1 | 2% |
| Other | 3 | 5% |
| Unknown | 11 | 17% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 March 2020.
All research outputs
#7,453,350
of 22,786,087 outputs
Outputs from Current Fungal Infection Reports
#43
of 156 outputs
Outputs of similar age
#42,127
of 119,835 outputs
Outputs of similar age from Current Fungal Infection Reports
#1
of 1 outputs
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So far Altmetric has tracked 156 research outputs from this source. They receive a mean Attention Score of 3.2. This one has gotten more attention than average, scoring higher than 70% of its peers.
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